Inspection on 15/03/06 for Tablehurst Farm Cottage

This inspection was carried out on 15th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tablehurst Farm Cottage 11/01/07

Tablehurst Farm Cottage 16/08/05

Tablehurst Farm Cottage 18/01/05

Tablehurst Farm Cottage 09/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Tablehurst Farm Cottage Tablehurst Farm Forest Row East Sussex RH18 5DP Lead Inspector Kevin Whatley Announced Inspection 15th March 2006 10:00 Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tablehurst Farm Cottage Address Tablehurst Farm Forest Row East Sussex RH18 5DP 01342 823536 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tablehurst Farm Limited Mr Peter Brown Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number must not exceed three The people accommodated will be adults between the ages of 18 and 65 years on admission 16th August 2005 Date of last inspection Brief Description of the Service: Tablehurst Farm Cottage is a family run home, providing accommodation for three adults with learning disabilities. The property is situated on a community organic farm, which is currently working 400 acres. There is a shop on site, which is used to sell the produce. Accommodation consists of three single rooms, a bathroom with bath and toilet and a separate toilet. There are currently two live-in staff members. The kitchen and lounge areas are shared with the live-in carers. The residents work on the farm and take part in the daily activities needed to run it. The Registered Provider and Registered Manager live in the main farmhouse. All farm staff and residents join together for meals that take place on a rotational basis in the different farm properties. There is also emphasis on integration into the wider community. Support is available to enable residents to go shopping, the cinema, swimming, and to undertake various other activities. Family and friends are made welcome and may join the small community for meals. Tablehurst Farm is inspired by Christian ideals as articulated by Rudolph Steiner and is based on the acceptance of spiritual uniqueness of each human being, regardless of religious or racial background. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Tablehurst Farm will be referred to as ‘residents’, and the live-in carers as ‘houseparents’. This announced inspection took place during a weekday in March beginning shortly after 10am and lasting for approximately four hours. The inspection included meeting with the registered managers of the home, the homes houseparents, a visiting parent of the one of the residents and speaking individually with all three residents. The inspection also included a tour of the premises and the farm itself, whilst each resident agreed to show the Inspector their bedrooms. A number of records and documents as required by registration were also viewed, whilst three pre-inspection questionnaires were received from relatives/carers and one the home is required to complete. The main focus of this inspection was to concentrate on the large number of requirements made as a result of the last inspection and to assess whether such requirements had been addressed by the home. It was pleasing to find that a majority of these requirements have been addressed, whilst others are in the process of being acted on. It is therefore most important that this report is read in conjunction with the last inspection report dated 16th August 2005. What the service does well: Tablehurst Farm provides residents with a high level of care and support within an atmosphere that appears inclusive and safe. The home environment offers residents a homely setting that is well maintained and equipped to meet their needs. Residents are clearly included in running of the farm and the ethos of the home, whilst being supported to be part of the local community. Resident’s personal wishes are acknowledged and acted upon, with residents stating that they feel ‘very happy’ and ‘looked after’ by the people who care for them. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Tablehurst Farm provides prospective residents and others with adequate information regarding the home and the services it offers, whilst the needs of residents are suitably assessed prior to admission. EVIDENCE: As stated in the previous report the service have developed a suitable statement of purpose and service user guide in a user friendly format which outlines the services it offers, the philosophy of the home and the farm and the ethos of the community they belong to. All three residents have lived at the home for over 18 months and indeed one for as long as ten years; no new resident has been admitted over the course of the last two inspections. Two care plans were seen and these confirmed that when residents are admitted to the home that they have had their care needs appropriately assessed. In both care plans there was a completed social services care needs assessment that outlined the needs of the resident and how such needs nave to be met. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9. The needs of residents are reflected in their individual plans of care, however behaviour management interventions need to be recorded. Suitable and comprehensive risk assessments ensure that residents are able to participate in the daily routines of the home and farm in a safe manner. EVIDENCE: Two care plans were viewed and these confirmed that all residents have care plans that reflect their individual needs and wishes, these are subsequently incorporated into daily care plans and routines. The previous report made a requirement regarding the need to record the nature of intervention given to one particular resident who could potentially display challenging behaviour, however the recording of such intervention has yet to be completed. Both the registered managers and house-parents displayed a clear and appropriate understanding of this residents challenging behaviour and most importantly the intervention strategies that help reduce the risk of such behaviour occurring; all parties agreed that such behaviour has not occurred since the new house-parents took over the running of the home in November 2005. All concerned acknowledged that despite the lack of Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 10 regularity that such behaviour could occur that the intervention strategies will now be recorded. Since the last inspection one of the new house-parents has completed risk assessments for all three residents when they are in the home or working on the farm. The risk assessments were seen to be comprehensive and robust and clearly detailed the nature of any risk, such as with machinery and open fires, and provided appropriate guidance of such risks can be reduced. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 and 16. Residents are supported and encouraged to pursue their own personal development. Residents are respected and their individual rights are acknowledged and appreciated. EVIDENCE: Tablehurst Farm places considerable importance on supporting the independent abilities of residents and all three residents are encouraged to engage in life skills development. This includes assisting with the preparation of all communal meals, making tea and coffee as and when they wish and most importantly working on the farm as part of the communal farm team. All three residents have been assisted to participate in most aspects of the day to day working of the farm and have been supported to develop the jobs and activities they most enjoy and appreciate. All residents commented that they enjoy the jobs they carryout on the farm and were clearly proud of their achievements in gaining and developing practical skills and experience and of being part of the farms communal workforce. The farm also has a shop on site that sells it’s organic meat, poultry and produce that member’s of the public can buy from three times a week. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 12 Residents often help out at the shop and noted that they enjoy meeting the public. One relative stated that residents are encouraged to participate in the routines of the home, farm and local community the same as any one else irrespective of any problems they may have, whilst another stated that their relative was extremely happy at the home. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21. The home have improved their medicine administration and storage system, though they should continue to develop it further. The individual wishes of residents and they families/carers in the event of illness or dying have been sensitively addressed. EVIDENCE: Since the last inspection the home have improved the recording of medicines given to residents with a book kept with individual records that include the type of medicine to be given. On viewing this book it appeared that records are maintained accurately and up to date, however it was also noted that just one signature/initial was being recorded for one resident who was receiving medication twice a day. Since the last inspection the home have also addressed the need to offer residents and their relatives/carers the opportunity to consider residents wishes in the event of them dying or becoming terminally ill. The home have improved their policy to include details of the approach the home takes in respect of this aspect of care and minutes were seen of a recent meeting that took place between the house-parents one resident and his relatives. This was seen to have been dealt with in an appropriate and sensitive fashion. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. The home have developed appropriate adult protection policies and procedures which help to keep residents safe from the risk of harm, neglect or abuse. EVIDENCE: Since the last inspection one of the house-parents has developed a new adult protection policy and procedure. The policy clearly outlines the definitions of vulnerability and abuse in a comprehensive yet easy to understand manner including the idea of ‘whistle blowing’. The adult protection procedures detail the actions that all staff must take if they suspect any concerns in regards neglect, harm or abuse. All staff in the home and those who work at the farm have to undertake an induction programme that includes reading the homes adult protection policies and procedures. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 and 30. Tablehurst Farm offers residents a high standard of accommodation in an environment that has been furnished in a homely and thoughtful manner. EVIDENCE: A tour of the premises confirmed that the home has been very well maintained both inside and out with all areas being found in a sound structural order with all décor being completed to a high standard. Since the last inspection the home have installed a new wood fired heating system that is fuelled by wood from the farm itself. All residents stated that they never felt cold, whilst the home felt warm with considerable naturally light throughout. The home was very clean and hygienic. All three residents agreed to show the Inspector their rooms. These were found to offer sufficient space, light and comfort with all rooms being individually furnished with pictures, ornaments and photographs. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35. Residents are protected by the homes recruitment practices, whilst care staff are experienced and pursuing necessary qualifications. EVIDENCE: Since the last inspection the home have improved their recruitment procedures and now ensure that all care staff have the necessary Criminal Records Bureau (CRB) and reference checks confirmed prior to working at the home. Staff records are maintained at the home in a locked cupboard. Both house-parents have experience of caring for people and are now enrolled to undertake the National Vocational Award (NVQ) level 2 in Care, both of them have recently undertaken training in first aid and health and safety. It was clear from observing interactions between staff and residents that care staff share appropriate relationships with the residents they care for, whilst their understanding of the needs of those they care for was both informed and relevant. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. The home is well run with the needs of residents remaining as paramount importance. The home have developed a suitable format for gaining feedback regarding the standard of care being offered by the service. Records and confidential information is suitably stored and health and safety issues adequately recorded. EVIDENCE: It was clear that Tablehurst Farm offers residents and those who live and work there a unique experience of being part of a virtually self-sufficient organic farming community that follows the guiding principles of Rudolf Steiner. The residential care home is part of this community and resident’s needs are obviously the main focus of those that run the service. Since the last inspection the home have developed a quality assurance questionnaire for relatives and carers to complete. The home intend to send this new questionnaire out to residents families and carers in the immediate future with the intention that they will carry this out once a year. The Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 18 questionnaire was seen to ask appropriate questions regarding standards of care, whilst allowing space for personal comments and views. All records and confidential information is stored securely in a locked cupboard. Since the last inspection the home have addressed the need for all maintenance of equipment in the home to be recorded. Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 3 X X 3 X 3 3 X Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement Timescale for action 15/03/06 2. YA20 It is required that care plans are updated to include any behaviour management guidelines (outstanding from the previous inspection). 13(2)17(1)(a)Sch3k It is required that every episode of medicine administration must be accompanied by a signature in the medicine administration book, ie a resident receiving medicines twice a day should have two signatures beside the times given. 15/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA23 Good Practice Recommendations That staff records should contain evidence of the date that they have read the homes adult protection policies and procedures. DS0000021383.V276948.R01.S.doc Version 5.1 Page 21 Tablehurst Farm Cottage Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tablehurst Farm Cottage DS0000021383.V276948.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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